An update from the <scp>WPA</scp> Working Group on Digitalization in Mental Health and Care
Authors: Umberto Volpe, Rodrigo Ramalho, Laura Orsolini, Ramdas Ransing, Renato de Filippis, Ahmet Gürcan, Shreyasta Samal, Wolfgang Gaebel
Journal: World Psychiatry (2023)

The treatment gap for persons with mental disorders averages 50% in all countries of the world and rises to 90% in least-resourced countries1. The mental health care sector is increasingly adopting newer digital health options that may help to significantly reduce this gap. Although telemental health care has a long-standing history and compelling empirical evidence base, its implementation in routine mental health care conditions has remained scant for many years2. However, following the COVID-19 pandemic, it represents now a routine clinical activity, and newer opportunities (as well as challenges) are rapidly emerging3. Digital (mental) health offers several valuable options (ranging from digital therapies to digital phenotyping, augmented reality, social media, artificial intelligence)4, 5 that will contribute significantly to deliver, support and enhance mental health care globally over the coming years6, being particularly appealing for younger generations7-9. However, the adoption of novel digital clinical options is occurring at different paces across countries, often with suboptimal implementation. Many national and international initiatives have been set up to promote digital mental health and care. For example, in Europe, a six-nation project has been implemented with the support of the European Regional Development Fund to increase the dissemination and quality of e-mental health services in Belgium, France, Germany, Ireland, The Netherlands, and the UK (e-Mental Health Innovation and Transnational Implementation Platform North-West Europe project; eMEN)10. The European Psychiatric Association also launched a series of initiatives (e.g., scientific symposia at its annual congresses, a task force on e-mental health, a series of training courses and a training video toolkit) to ensure a more even spread of digital mental health across Europe11. According to recent evidence, digital mental health interventions in lower income countries may represent a valuable option, if adequately implemented and evaluated12. Thus, further action is required to ensure the equitable implementation and impact of digital mental health at a global scale. The WPA Working Group on Digitalization in Mental Health and Care is aiming at the improvement of global mental health and care by introducing digital tools and programs, thereby contributing to transforming health systems for universal health coverage. The Working Group, appointed in 202013 and chaired by W. Gaebel, U. Volpe and R. Ramalho, is working alongside experts in the field of digital psychiatry and WPA early career psychiatrists. Currently, the Working Group is collaborating with WPA Member Societies, drawing a baseline on global digitalization in mental health and care by means of an international survey. The survey covers topics ranging from the grade of digitalization in general and mental health care, to the availability of national policies and regulations, barriers and facilitators for implementation, guidelines for tools and interventions, and capacity building by education and training. Building on the results, the WPA Working Group is going to transform and support the national digital infrastructures together with the Member Societies and other stakeholders, including patient and family organizations. The collaboration with WPA Member Societies will also contribute to produce evidence-based guidelines for safe and ethical use of digital mental health options at the individual, institutional and country level, including awareness building and improving digital literacy, also fostering implementation research of digital mental health and care. The WPA Working Group is also developing and delivering scientific and training initiatives, including symposia and workshops at national and international levels. It is contributing to World Congresses of Psychiatry, e.g., the one held in Bangkok in 2022, where an in-person course on "Digitalization in Mental Health and Care" was organized from a worldwide perspective. At the same Congress, an online symposium on worldwide digitalization in mental health and care was organized by the WPA Working Group to help define methods of rapid implementation of telepsychiatry, explore the need for standardized training curricula for global digital psychiatry, and identify facilitators and barriers for cultural safety in e-mental health. The WPA Working Group will also deliver a course on digitalization in daily clinical work at the upcoming WPA Congress of Psychiatry to be held in Vienna, Austria. Considering the fast evolving pace of digital technologies, as per WPA request, the Working Group is currently finalizing a new WPA Position Statement on Digitalization in Mental Health and Care, also to update the previous WPA Position Statement on e-Mental Health. To this aim, an exhaustive review of the current evidence on the global level of digitalization in mental health and care has been carried out. This new Position Statement will provide the WPA and its Member Societies with a roadmap on high priority and targeted interventions to support implementation and upscaling of digital mental health and care in global mental health systems.